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Ohio rates for HCPCS Q4158

Kerecis Omega3, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.27 / $67.27 / $304.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $69.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $78.03 / $139.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.27 / $67.27 / $114.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $90.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.47 / $63.47 / $67.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $95.20
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.32 / $176.32 / $176.32
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $109.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.98 / $72.95 / $73.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $85.97